CSPI Reports

Dine at Your Own Risk -- Part IV

Food Safety Standards That Many Inspection Agencies Do Not Follow

None of the state and local agencies surveyed are following all of FDA's Food Code
recommendations. Many agencies are not requiring restaurants to cook food at temperatures that
kill bacteria and to cool and refrigerate it at temperatures that keep bacteria from multiplying.
Most agencies are not requiring restaurants to warn consumers of the dangers of eating
potentially dangerous raw foods, such as shellfish. Many agencies are not inspecting restaurants
every six months. Key findings include:

Only 13% of the agencies surveyed enforce the FDA Food Code recommended cooking
temperatures for pork, eggs, fish, and poultry, and only 64% require hamburgers to be cooked
to 155F, the temperature necessary for E. coli O157:H7 to be destroyed in 15 seconds.

Only 11% of the agencies require refrigeration of food at the temperature recommended by
FDA.

Less than half of the agencies who responded inspect restaurants twice a year.

Only 16% of the agencies require consumer warnings for raw food, like shellfish, and
undercooked food, like rare hamburgers.

Insuring Adequate Cooking of Food

Cooking Temperature Requirements for Pork, Eggs, Fish, and Poultry

Because inadequate cooking is a leading cause of foodborne illness, the FDA Food Code
recommends specific cooking temperatures for raw pork, eggs, fish and poultry. Poultry should
be heated to 165F; pork and processed fish should be heated to 155F; and whole fish should be
heated to 145F. Eggs cooked in response to a customer's order for immediate service should
also be heated to 145F.

CSPI asked the inspection agencies about their cooking temperature requirements for pork, eggs,
fish, and poultry. Only 13% of responding agencies follow the Food Code's cooking temperature
recommendations for all four foods. (See Figure I )

Most of the other 87% of agencies have cooking temperature standards for at least some of those
foods, but the required temperatures often may not be high enough to kill bacteria that can cause
illness or death. For pork, 62% of responding agencies have cooking temperatures lower than the
recommended temperature of 155F, and 9% have no standard at all. Pork can contain Trichinella
spiralis, a parasite that causes serious illness, and the bacteria Salmonella and Campylobacter,
which can be killed only by thorough cooking. For eggs, 38% of localities have
lower-than-recommended cooking temperatures, and 38% have no standard at all. For fish, 36%
have lower-than-recommended cooking temperatures, and 44% have no standard at all. For
poultry, 86% follow the FDA recommended temperatures, while 7% do not have a standard.
Three health departments, including two in California, have no required cooking temperatures in
their codes.

Cooking Temperature Requirements for Hamburger

In order to kill deadly E. coli O157:H7 bacteria that may be present in ground beef, the FDA
Food Code recommends that hamburgers be cooked at an internal temperature of 155F for 15
seconds. Despite the numerous outbreaks from this strain of E. coli, 20% of the agencies
surveyed fail to apply this standard and 16% have no temperature requirement at all. (See Figure
II)

Refrigerating Food at Proper Temperature

The FDA Food Code recommends a cold storage temperature of 41F for all raw and cooked
food that needs to be refrigerated. Only 11% of inspection agencies surveyed require
refrigeration of potentially hazardous food to 41F. The other 89% require a cold storage
temperature at or below 45F. (See Figure III)

The dangers of inadequate refrigeration are well known. Certain types of Listeria and Clostridium
botulinum continue to multiply slowly in foods at temperatures of 45F. Those pathogens must be
chilled to 41F to stop their growth.

Cooling Previously Cooked Food

The 1995 FDA Food Code recommends that cooked, potentially hazardous food be cooled from
140F to 70F within two hours and from 70F to 41F within four hours. Only 20% of state and
local health departments surveyed enforce this standard. (See Figure IV) Most require a low
temperature of 45F, not the 41F necessary to prevent some pathogens from multiplying.

Rapid cooling is best done by placing food into shallow containers and then placing the containers
in a rapid chill device such as an ice bath. Using shallow containers is important if the food is to
be adequately cooled. Food heaped higher than four inches generally will not cool rapidly enough
in a refrigerator.

Inspecting Restaurants Frequently and Thoroughly

Frequency of Inspections

The FDA Food Code recommends that restaurants be inspected at least once every six months.
Sixty-seven percent of the 33 surveyed agencies that gave CSPI inspection data stated that they
follow or exceed this recommendation, while 33% said they inspect less than twice a year. (See
Figure V)

To test the accuracy of those responses, CSPI asked respondents for data on the number of
restaurants in their jurisdiction as well as the actual number of restaurant inspections performed in
1994. Based on those numbers, only 48%, not 67%, of the agencies inspected restaurants twice
or more a year. (See Figure VI) In other words, 22 agencies told CSPI they inspect more than
twice a year, but based on their own 1994 data, only 16 were actually doing so.

When agencies do not inspect restaurants frequently enough, violations could go unchecked for
months, increasing the risk of food poisoning.

Average Length of Inspections

The average length of time agencies reported spending on an inspection was one hour and 14
minutes. Officials in Los Angeles and San Francisco, California, reported spending an average of
just under 40 minutes on each inspection; the agency in Las Vegas, Nevada, spends about 35
minutes; and the agency in Hartford, Connecticut, spends only 20 minutes unless it has received a
complaint about a restaurant. In contrast, inspections in Baltimore, Maryland, average three
hours in length, and in the state of Rhode Island, two- and-a-half hours.

The FDA Food Code does not specify the amount of time an inspection should take. However,
during an inspection, an inspector should check and document food temperatures, cooling
procedures, storage facilities, cleanliness, staff hygiene and other potential areas of risk. Food
safety could be compromised if inspections are not thorough.

Laboratory Testing

At least three of the 45 inspection agencies surveyed send food samples taken from restaurants
during routine inspections to a laboratory to be tested for the presence of foodborne pathogens.
Budget constraints were cited by some agencies as the primary reason for not doing random
laboratory testing. However, many agencies emphasized that lab testing was done to confirm a
suspicion of a food poisoning outbreak or when investigating a complaint against a food service
establishment.

Warning Consumers About Risky Food

Raw oysters and other shellfish can carry the deadly Vibrio bacteria. Rare ground beef can harbor
E. coli O157:H7 and undercooked eggs can contain Salmonella. Yet, many vulnerable consumers
are not informed of these health hazards and continue to eat raw or undercooked animal food.

According to the FDA Food Code, restaurants should post warning notices on menus, table signs,
or elsewhere in the restaurant, stating the danger to vulnerable consumers of eating raw or
undercooked animal food such as meat or shellfish. Only 16% of the 45 inspection agencies
surveyed require restaurants and other food service establishments to post a consumer advisory.
The agency in Tampa, Florida, follows Florida state law requiring a consumer advisory only for
raw oysters.

Visits to restaurants in some of the jurisdictions that require such advisories showed that the
advisories are often not in place. A seafood restaurant in San Francisco, California, that serves
raw oysters, a sushi restaurant in Long Beach, California, and a restaurant that serves raw oysters
in Orlando, Florida, all failed to provide any kind of consumer advisory. Of the four restaurants
visited, only an oyster bar in Providence, Rhode Island, provided warnings of the hazards of
eating raw food.

The raw oyster advisory in Florida was implemented following numerous deaths in that state from
the consumption of raw shellfish. However, a 1995 University of Florida study showed that only
66% of Florida restaurants were actually complying with the consumer advisory law.